title: Is the Life Space Assessment applicable to a palliative care population? Its relationship to measures of performance and quality of life.
abstract: BACKGROUND
  The spatial environments that palliative care patients frequent for business and leisure constrict as their disease progresses and their physical functioning deteriorates. Measuring a person's movement within his or her own environment is a clinically relevant and patient-centered outcome because it measures function in a way that reflects actual and not theoretical participation.
  
  
  OBJECTIVE
  This exploratory study set out to test whether the Life-Space Assessment (LSA) would correlate with other commonly used palliative care outcome measures of function and quality of life.
  
  
  METHODS
  The baseline LSA, Australia-modified Karnofsky Performance Status Scale (AKPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative (EORTC QLQ-C15-PAL) scores from two large clinical trials were used to calculate correlation coefficients between the measures. Convergent validity analysis was undertaken by comparing LSA scores between participants with higher (≥70) and lower (≤60) AKPS scores.
  
  
  RESULTS
  The LSA was correlated significantly and positively with the AKPS, with a moderate correlation coefficient of 0.54 (P<0.001). There was a significant weak negative correlation between the LSA and the EORTC QLQ-C15-PAL, with a small coefficient of -0.22 (P=0.027), but a strong correlation between the LSA and the EORTC QLQ-C15-PAL item related to independent activities of daily living (r=-0.654, P<0.01). A significant difference in the LSA score between participants with higher (≥70) and lower (≤60) AKPS scores t(97)=-4.35, P<0.001) was found.
  
  
  CONCLUSIONS
  The LSA appears applicable to palliative care populations given the convergent validity and capacity of this instrument to differentiate a person's ability to move through life-space zones by performance status. Further research is required to validate and apply the LSA within community palliative care populations.
authors.affiliation: The Cunningham Centre for Palliative Care, Sacred Heart Health Care, St. Vincent's Hospital Sydney, and School of Nursing, The University of Notre Dame, Sydney. Electronic address: jphillips@stvincents.com.au.
authors.forename: Jane Louise
authors.initials: JL
authors.lastname: Phillips
authors.affiliation: Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong SAR; Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lam
authors.affiliation: Faculty of Health, University of Technology Sydney, Ultimo, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Luckett
authors.affiliation: Braeside Palliative Care Service, Hammond Care, and School of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Meera
authors.initials: M
authors.lastname: Agar
authors.affiliation: Flinders University and Southern Adelaide Palliative Care Service, Daw Park, South Australia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Currow
mesh_terms: D000368:Aged; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires
keywords: Hospice; activities of daily living; mobility; outcome measures; palliative care; performance status; quality of life; validation